There is a dearth of research addressing the physical and mental health, HIV risk behaviors, and HIV prevention needs of Native Americans. Among HIV+ individuals, Native Americans experience mental health, alcohol/drug abuse, and antiretroviral medication utilization disparities. This study employs a mixed methodological design, combining qualitative and quantitative methodologies and proposes two innovative and significant aims. First, I will conduct a qualitative study with HIV+ Native Americans and HIV service providers to identify and examine the barriers to HIV service utilization; to explore the relationship of holistic care to service utilization; and, to explore the role and nature of spirituality in coping with living with HIV. Second, I will conduct a secondary data analyses on a national pilot study of a community-based sample of 130 HIV+ urban Native Americans to analyze the reliability and validity of spirituality measures among this population; and to examine spirituality as a mediator and moderator of the impact of discrimination and trauma in relation to health outcomes, including mental and physical health, related risk behaviors (sexual and alcohol/drug), and medication adherence. [unreadable] [unreadable] [unreadable]